BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  SB 1014
                                                                  Page  1

          Date of Hearing:   June 17, 2014

           ASSEMBLY COMMITTEE ON ENVIRONMENTAL SAFETY AND TOXIC MATERIALS
                                  Luis Alejo, Chair
                    SB 1014 (Jackson) - As Amended:  June 10, 2014

           SENATE VOTE  :  33-3
           
          SUBJECT  :  Pharmaceutical waste:  home generated:  collection.

           SUMMARY  :  Requires the Department of Resources Recycling and  
          Recovery (CalRecycle) and the California State Board of Pharmacy  
          to jointly develop regulations authorizing a voluntary program  
          to collect and properly dispose of home-generated pharmaceutical  
          waste (HGPW).  Specifically,  this bill  :   

          1)Authorizes a pharmacy to accept the return of HGPW from a  
            consumer, consistent with the Federal Food, Drug, and Cosmetic  
            Act and the federal Controlled Substances Act.

          2)Defines HGPW as a prescription or over-the-counter human or  
            veterinary home-generated pharmaceutical, including a drug  
            that is a waste, derived from a household, including a  
            multifamily residence or household.

          3)Specifies that HGPW, including consolidated HGPW that is  
            handled by a collection and disposal program operating in  
            accordance with the regulations adopted by CalRecycle is not  
            medical waste.  
           
          4)Defines terms, including: 

             a)   "Consumer" as an individual purchaser or owner of a  
               pharmaceutical.  Specifies that "consumer" does not include  
               a business, corporation, limited partnership, or an entity  
               involved in a wholesale transaction between a distributor  
               and retailer;

             b)   "Entity" as a state or local public agency, pharmacy,  
               veterinarian clinic, or other office or facility; and,

             c)   "Participant" as an entity that CalRecycle deems  
               appropriate for implementing and evaluating a program in  
               accordance with the HGPW regulations and that chooses to  
               participate.








                                                                  SB 1014
                                                                  Page  2


          5)Requires, by January 1, 2016, CalRecycle and the California  
            State Board of Pharmacy to jointly develop regulations, to be  
            approved by both agencies before adoption, authorizing a  
            participant to establish a program to collect and properly  
            dispose of HGPW.  Requires the regulations to be based upon  
            the model guidelines developed by CalRecycle and to require a  
            participant to do the following:

             a)   Provide, at no additional cost to the consumer, for the  
               safe take back and proper disposal of pharmaceuticals;

             b)   Ensure the protection of the public health and safety,  
               the environment, and the health and safety of consumers and  
               employees;

             c)   Report to CalRecycle for purposes of evaluation the  
               safety, efficiency, and effectiveness of the implemented  
               program on an annual basis; 

             d)   Protect against the potential for the diversion of  
               pharmaceutical waste for unlawful use or sale; and,

             e)   Provide notices and materials, as specified, to  
               consumers that provide information about the potential  
               impacts of improper disposal of HGPW and the return  
               opportunities for the proper disposal of HGPW.  

          6)Requires the HGPW regulations to do all of the following:

             a)   Specify the types of participants authorized to maintain  
               permanent collection locations;

             b)   Specify any requirements for obtaining state permits or  
               approvals;

             c)   Require participants to enter into arrangements with  
               medical or hazardous waste haulers, including ensuring that  
               all HGPW is appropriately picked up and transported by  
               registered waste haulers;

             d)   Specify which HGPW may be included in a program,  
               including requirements for the collection of a controlled  
               substance;









                                                                  SB 1014
                                                                  Page  3

             e)   Specify methods for handling wastes commingled in  
               containers with other household waste or hazardous waste;

             f)   Provide methods for collecting and storing HGPW,  
               including the use of secured containers, and ensure that  
               collected HGPW is not resold, reused, sold, donated, or  
               provided to anyone other than a registered medical or  
               hazardous waste hauler;

             g)   Provide that a facility that collects HGPW is  
               responsible for ensuring that the storage, removal, and  
               transportation of containers and the disposal of the waste  
               are in compliance with state laws and regulations;

             h)   Require the collection and retention of detailed  
               information and invoices for each collection site; 

             i)   Impose requirements for one-time or periodic collection  
               events and for mail-back collection and disposal programs;  
               and,

          7)Requires CalRecycle to include in the regulations provisions  
            for the appropriate management of consolidated HGPW to ensure  
            the public health and safety.

          8)Deems a participant operating a program in accordance with the  
            HGPW regulations to be in compliance with all state laws and  
            regulations concerning the handling, management, and disposal  
            of HGPW.

           EXISTING LAW  :

          Requires, under the federal Controlled Substances Act, protocols  
          for the collection of controlled substances to prevent their  
          illegal diversion and abuse. (21 U.S.C. Sec. 801 et seq.)

          Establishes the Federal Food, Drug, and Cosmetic Law,  
          administered by the Department of Public Health (DPH), to  
          regulate drugs and medical devices.  (21 U.S.C. Sec. 301 et  
          seq.)

          Pursuant to the Business and Professions Code (BPC):

          1) Establishes the Pharmacy Law, which provides for the  
             licensure and regulation of pharmacies, pharmacists, and  








                                                                  SB 1014
                                                                  Page  4

             wholesalers of dangerous drugs or devices by the Board of  
             Pharmacy within the Department of Consumer Affairs.  (BPC �  
             4000 et seq.)

          2) Authorizes a pharmacy to accept the return of needles and  
             syringes from the public if contained in a sharps container.   
             (BPC � 4146)
          
          Pursuant to the Health and Safety Code (HSC):

          1) Establishes the California Uniform Controlled Substances Act,  
             which regulates controlled substances.  (HSC � 11000 et seq.)

          2) Defines a drug as substances recognized as drugs in the  
             official United States Pharmacopoeia, official Homeopathic  
             Pharmacopoeia of the United States, or official National  
             Formulary, or any supplement to any of them; substances  
             intended for use in the diagnosis, cure, mitigation,  
             treatment, or prevention of disease in man or animals; and,  
             substances (other than food) intended to affect the structure  
             or any function of the body of man or animals.  (HSC � 11014)

          3) Establishes the Medical Waste Management Act (MWMA) which  
             regulates the generation, handling, storage, transport,  
             treatment, and disposal of medical waste, as defined, and is  
             overseen by DPH and designated local agencies.  (HSC �117600  
             et seq.)

          4) Defines "household waste" as any material, including garbage,  
             trash, and sanitary wastes in septic tanks and medical waste  
             that is derived from households, farms, or ranches.  (HSC �  
             117670)

          5) Defines "pharmaceuticals" as a prescription or  
             over-the-counter human or veterinary drug including, but not  
             limited to, a drug as defined in the Sherman Food, Drug and  
             Cosmetic Law or the Federal Food, Drug, and Cosmetic Act.   
             Excludes for the definition of "pharmaceutical" any  
             pharmaceutical that is regulated pursuant to the federal  
             Resource Conservation and Recovery Act (RCRA) of 1976, which  
             governs the management of solid and hazardous wastes, or the  
             Radiation Control Law.  (HSC � 117747)

          6) Defines "pharmaceutical waste" as any pharmaceutical that for  
             any reason may no longer be sold or dispensed for use as a  








                                                                 SB 1014
                                                                  Page  5

             drug, and excludes from this definition those pharmaceuticals  
             that still have potential value to the generator because they  
             are being returned to a reverse distributor for possible  
             manufacturer credit.  (HSC � 117748)

          7) Specifies that waste comprised only of pharmaceuticals is  
             biohazardous, and is considered "medical waste."  (HSC �  
             117635)

          8) Requires all medical waste be transported to an offsite  
             medical waste treatment facility to be transported by a  
             registered hazardous waste transporter.  (HSC � 118000)

          9) Establishes a voluntary drug repository and distribution  
             program for the purpose of distributing surplus medications  
             to persons in need of financial assistance to ensure access  
             to necessary pharmaceutical therapies.  (HSC � 150200 et  
             seq.)

          Pursuant to the Public Resources Code (PRC):

          1) Requires pharmaceutical manufacturers that sell or distribute  
             a medication in California that is self-injected at home  
             through the use of a hypodermic needle, pen needle,  
             intravenous needle, or any other similar device to submit to  
             CalRecycle a plan that describes what actions, if any, the  
             manufacturer supports for the safe management of sharps  
             waste.  
          (PRC � 47115)


           FISCAL EFFECT  :  Unknown.

           COMMENTS  :   

           Need for the bill  :  According to the author, "California is  
          experiencing an increasingly serious problem with prescription  
          drug abuse, accidental poisonings, and the detection of  
          pharmaceutical products in state waters.  Local governments have  
          struggled to establish safe and convenient medication take-back  
          programs for the unused and expired prescription drugs, over the  
          counter drugs, and veterinary drugs found in our homes.  Unused  
          medications are often flushed or thrown in the trash because  
          there are few, if any, safe and convenient options?  Now that  
          CalRecycle's Model Guidelines have expired, there are no  








                                                                  SB 1014
                                                                  Page  6

          standards in place for how local entities should properly run  
          their voluntary take-back programs to ensure that collection and  
          disposal is safe, convenient, and secure.  Due to the  
          prescription drug abuse epidemic in the state, guidelines for  
          collection to prevent further diversion are critical to  
          protecting public health-they can help by providing local  
          entities with a model for removing unwanted drugs from homes and  
          ensuring they are not resold or available to be abused after  
          consolidation at collection locations."

           Impacts of improper disposal of pharmaceuticals  :  CalRecycle  
          asserts that pharmaceutical wastes are a societal problem  
          because they show up in the environment, particularly in our  
          waterways, and because some are "controlled substances" that can  
          be illegally diverted and abused.  A U.S. Geological Survey  
          study conducted in 2002 found that 80 percent of streams sampled  
          in 30 states had measurable concentrations of prescription and  
          nonprescription drugs, steroids, and reproductive hormones.   
          Studies show that exposure even to low levels of pharmaceuticals  
          has negative effects on fish and other aquatic species and may  
          negatively affect human health.  CalRecycle notes that  
          accidental prescription overdoses, teen and adult abuse of  
          prescription drugs, and impacts to surface waters and  
          groundwater when drugs are flushed down the toilet, all  
          highlight the need for safe pharmaceutical waste collection  
          programs.  

           The model HGPW collection and disposal program  :  Senate Bill 966  
          (Simitian, Chapter 542, Statutes of 2007) requires the  
          California Integrated Waste Management Board (CIWMB), which is  
          the predecessor to CalRecycle, to develop model programs for the  
          collection from consumers and proper disposal of unused or  
          expired home-generated pharmaceuticals.  The CIWMB was also  
          required, when developing model programs, to evaluate programs  
          used by other state, local, and governmental entities, which it  
          did by survey.  CalRecycle reports that it developed the  
          "Criteria and Procedures for Model Home-Generated Pharmaceutical  
          Waste Collection and Disposal Programs," which was adopted in  
          2010, based on the survey results and in consultation with the  
          Pharmaceutical Working Group, which included staff from CIWMB,  
          DPH, Board of Pharmacy, DTSC, and the State Water Resources  
          Control Board.  The model program was meant to assist  
          organizations and local governments in creating programs through  
          which the public may return unused or expired HGPW, as well as  
          to meet the minimum criteria and goals delineated in SB 966.  








                                                                  SB 1014
                                                                  Page  7


          SB 966 required, at a minimum, the model programs to include: 

          1)A means by which a participant is required to provide, at no  
            additional cost to the consumer, for the safe take back and  
            proper disposal of drugs; 

          2)A means by which a participant is required to ensure the  
            protection of public health and safety, the environment, and  
            the health and safety of consumers and employees; 

          3)A means by which a participant is required to report on the  
            program for safety, efficiency, effectiveness, and funding  
            sustainability;

          4)A means by which a participant shall protect against the  
            potential for the diversion of drug waste for unlawful use or  
            sale; and, 

          5)Providing notice and informational materials for consumers  
            about the potential impacts of improper disposal of drug waste  
            and the return opportunities for the proper disposal of drug  
            waste.

          The regulatory requirements in SB 1014 are based upon the  
          minimum requirements for HGPW model programs as required by SB  
          966.

           CalRecyle's HGPW report and recommendations  :  SB 966 also  
          required CalRecycle to prepare a report for the Legislature that  
          evaluated California's pharmaceutical waste collection programs  
          and provided recommendations to the Legislature for the  
          potential implementation of a statewide program and statutory  
          changes.  CalRecycle submitted Report to the Legislature:  
          Recommendations for Home-Generated Pharmaceutical Collection  
          Programs in California, in December 2010, in which it  
          recommended that the Legislature adopt a combination of two  
          options related to pharmaceutical waste collection programs:  1)  
          statutory changes to establish clear state roles and  
          responsibilities, provide direction to resolve several  
          implementation challenges, and direct that the "Criteria and  
          Procedures for Model Home-Generated Pharmaceutical Waste  
          Collection and Disposal Programs" be refined and converted into  
          regulations; and 2) statutory direction to address funding  
          barriers by providing financing through a private sector  








                                                                  SB 1014
                                                                  Page  8

          approach with government oversight, commonly referred to as  
          product stewardship. 

          SB 1014 is consistent with the first recommendation in the  
          report, which suggests that the "Criteria and Procedures for  
          Model Home-Generated Pharmaceutical Waste Collection and  
          Disposal Programs" be refined and converted into regulations.

           Have the model guidelines been effective  ?  While the statute  
          that required the HGPW model guidelines became inoperative on  
          January 1, 2013, entities can currently continue to follow the  
          guidelines.  CalRecycle's 2010 report states that, based on  
          available information at the time, collection programs in  
          California gathered approximately 200,000 pounds of HGPW per  
          year.  CalRecyle notes that these collection programs appear to  
          be quite safe with very low illegal diversion.  Out of 256  
          collection sites, which represents 86 percent of all known  
          programs operating in California, a CalRecycle survey found that  
          in the previous 15 years there were no reported signs of illegal  
          drug diversion.  CalRecyles asserts, however, that these  
          programs likely collect a small percentage of all home-generated  
          pharmaceutical waste.  Of the approximately 61,000 pharmacies in  
          California, the number of pharmaceutical collection programs was  
          around 300 in 2010, with no large chain pharmacies participating  
          in the program.  Only about one-third of the programs met the  
          voluntary model guidelines.

          A 2014 CalRecycle report to the California State Senate  
          suggested that program participants face a number of challenges  
          that have limited program participation.  These challenges  
          include:  1) local governments fund more than 80% of all  
          programs; 2) stakeholders consider the costs to be too high; 3)  
          under statute, HGPW is solid waste, but per DPH policy, it is a  
          medical waste when consolidated, therefore participation  
          requires compliance with tracking standards, medical waste  
          hauling standards, and disposal standards; and, 4) the  
          regulatory requirements, policies, and authority are too complex  
          (HGPW regulators and governmental stakeholders include: DPH,  
          Board of Pharmacy, DTSC, the State Water Resources Control  
          Board, the U.S. Drug Enforcement Administration, etc.).  Should  
          this bill be enacted, the regulations required by this bill will  
          need to address some of these challenges in order for the HGPW  
          take-back program to be effective.  

           Two different regulatory systems  :  SB 1014 clarifies that HGPW,  








                                                                  SB 1014
                                                                  Page  9

          even if it is consolidated, is excluded from the definition of  
          medical waste if it is being handled by a collection and  
          disposal program operating in accordance with the regulations  
          required in the bill.  DPH policy will likely still consider  
          HGPW that is not part of the program set up in the bill to be  
          medical waste when consolidated.  Should this bill be enacted,  
          two different management systems for HGPW could exist, as some  
          will be considered medical waste, and some HGPW.

           Double referral  :  This bill is double referred to the Assembly  
          Business and Professions Committee.

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          Alameda County Board of Supervisors (co-sponsor)
          California Product Stewardship Council (co-sponsor)
          California Alliance for Retired Americans (co-sponsor)
          Clean Water Action (co-sponsor)
          California Association of Sanitation Agencies
          Californians Against Waste 
          Californians for a Healthy & Green Economy
          California Resource Recovery Association
          California State Board of Pharmacy
          California State Sheriff's Association
          Center for Environmental Health
          City of Camarillo
          City of Chula Vista
          City of Roseville
          City of Thousand Oaks
          City of Torrance
          County of Santa Clara
          County Sanitation Districts of Los Angeles County
          East Bay Municipal Utility District
          El Dorado Irrigation District
          Health Officers Association of California
          League of Women Voters of California
          Los Angeles County Board of Supervisors
          Marin Sanitary Service
          Natural Resources Defense Council
          Pajaro Valley Community Health Trust
          Sacramento State Student Health Services Pharmacy
          San Francisco Bay Area Physicians for Social Responsibility
          San Mateo County Board of Supervisors 








                                                                  SB 1014
                                                                  Page  10

          Santa Cruz County Board of Supervisors
          Scan Davison
          Worksafe
           
            Opposition 
           
          One individual.

           Analysis Prepared by  :  Shannon McKinney / E.S. & T.M. / (916)  
          319-3965